Enter by the narrow gate; for the gate is narrow and the way is hard, that leads to life, and those who find it are few…(Mt 7:13-14)
Today was the final day of radiation treatments for the metastatic lesions found in Theresa’s spine and femur. They provided her with a flower and certificate of completion. I smiled at the flower and was happy that this particular regimen is finished. I try not to get too excited when something goes well, as well as not getting too sad when things aren’t going well. It’s one way to maintain some sense of control and sanity.
In the afternoon, we met with Dr. Pavani Chalasani, the oncologist who is taking over treatment for Theresa while her original oncologist recovers from an illness. Dr. Chalasani provided some direction on how we should go forward. The new drug regimen is the use of Gemcitabine and Cisplatin. On day one, both drugs will be administered. One week later, a dose of Gemcitabine will be administered and will be followed up the next day by a Neulasta injection. This treatment will start on April 14th. The schedule has a week break between rounds which means there will be no treatment administered during the week of our 21st wedding anniversary!
The combination of Gecitabine and Cisplatin was a clinical trial that took place around 2007-2008. It was developed to treat patients with metastatic breast cancer who had been pretreated with anthracycline and taxane (ACT). The ACT treatment was the original one prescribed and taken during 2015. One study showed a partial response in 29% of patients and a stable response in 39% of the patients. The plan is to revisit the treatment after 2 cycles to assess how things are going.
The other thing put forward by Dr. Chalasani was to take part in a clinical trial that is ongoing which uses an immunotherapy regimen that targets a protein on white blood cells called PD-1. PD-1 normally maintains the balance of the immune system by shutting it down at the right time. Some cancers take advantage of this mechanism by expressing PD-L1, enabling them to escape attack by the body’s white blood cells. The immunotherapy regimen works by blocking PD-1, enhancing the body’s ability to detect and destroy cancer cells. The doctor wants very much to explore clinical trials as this cancer has not responded to the normal drug treatments.
Interestingly, this clinical trial mirrors one that a Diaconate classmate forwarded to me back in March. He is a PhD drug researcher and suggested looking up this treatment. We are going to pursue enrollment in the trial as we need to think outside of the box. I am not a doctor, but I am a well trained investigator and interrogator. One of my skills is to read between the lines at what is being said and look for elements of the truth that may be lurking between those lines. I get the sense that the Gemcitabine/Cisplatin regimen will be the last “normal” regimen we try if it does not work. More than likely, any future treatment regimen will be clinical trials.
I’ve been telling those who ask for an update on Theresa that we really need some wins in the fight. We’ve been fighting bad news/setbacks since November and it seems to be everywhere present and has been winning every battle. I’m tired of playing defense. Let’s go offensive and win a few battles! My quote from Matthew is clearly taken out of context from it original scriptural meaning, but it is fitting. This path we are on is narrow and hard, but it is the only one that can lead to life.